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METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 401k Plan overview

Plan NameMETZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN
Plan identification number 001

METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

METZNER'S CULLIGAN QUALITY WATER has sponsored the creation of one or more 401k plans.

Company Name:METZNER'S CULLIGAN QUALITY WATER
Employer identification number (EIN):391078407
NAIC Classification:453990

Form 5500 Filing Information

Submission information for form 5500 for 401k plan METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01ALENA SCHUESSLER2023-09-26
0012021-01-01ALENA METZNER2022-07-25 ALENA METZNER2022-07-25
0012020-01-01ALENA METZNER2022-03-15 ALENA METZNER2022-03-15
0012020-01-01ALENA METZNER2022-03-15 ALENA METZNER2022-03-15
0012019-01-01ALENA METZNER2020-06-11 ALENA METZNER2020-06-11
0012018-01-01ALENA METZNER2019-07-12 ALENA METZNER2019-07-12
0012017-01-01ALENA METZNER2018-10-15 ALENA METZNER2018-10-15
0012016-01-01ALENA METZNER2017-08-02 ALENA METZNER2017-08-02
0012015-01-01ALENA METZNER2016-07-27 ALENA METZNER2016-07-27
0012014-01-01ALENA METZNER
0012013-01-01ALENA METZNER
0012012-01-01MARK METZNER
0012011-01-01MARK METZNER
0012010-01-01MARK METZNER
0012009-01-01MARK METZNER
0012009-01-01

Plan Statistics for METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN

401k plan membership statisitcs for METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN

Measure Date Value
2014: METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0113
Total number of active participants reported on line 7a of the Form 55002014-01-0112
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-012
Total of all active and inactive participants2014-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0114
Number of participants with account balances2014-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0111
Total number of active participants reported on line 7a of the Form 55002013-01-0110
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-012
Total of all active and inactive participants2013-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0112
Number of participants with account balances2013-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0111
Total number of active participants reported on line 7a of the Form 55002012-01-019
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-012
Total of all active and inactive participants2012-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0111
Number of participants with account balances2012-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0111
Total number of active participants reported on line 7a of the Form 55002011-01-0110
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0110
Number of participants with account balances2011-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0112
Total number of active participants reported on line 7a of the Form 55002010-01-0110
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0110
Number of participants with account balances2010-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0119
Total number of active participants reported on line 7a of the Form 55002009-01-0112
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-013
Total of all active and inactive participants2009-01-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0115
Number of participants with account balances2009-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN

Measure Date Value
2014 : METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total income from all sources2014-12-31$78,528
Expenses. Total of all expenses incurred2014-12-31$140,000
Benefits paid (including direct rollovers)2014-12-31$140,000
Total plan assets at end of year2014-12-31$588,267
Total plan assets at beginning of year2014-12-31$649,739
Value of fidelity bond covering the plan2014-12-31$50,000
Total contributions received or receivable from participants2014-12-31$21,942
Expenses. Other expenses not covered elsewhere2014-12-31$0
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$52,534
Net income (gross income less expenses)2014-12-31$-61,472
Net plan assets at end of year (total assets less liabilities)2014-12-31$588,267
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$649,739
Assets. Value of participant loans2014-12-31$32,548
Total contributions received or receivable from employer(s)2014-12-31$4,052
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Funding deficiency by the employer to the plan for this plan year2014-12-31$0
Minimum employer required contribution for this plan year2014-12-31$0
Amount contributed by the employer to the plan for this plan year2014-12-31$0
2013 : METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total income from all sources2013-12-31$139,675
Expenses. Total of all expenses incurred2013-12-31$35,417
Benefits paid (including direct rollovers)2013-12-31$35,417
Total plan assets at end of year2013-12-31$649,739
Total plan assets at beginning of year2013-12-31$545,481
Value of fidelity bond covering the plan2013-12-31$50,000
Total contributions received or receivable from participants2013-12-31$21,129
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$114,414
Net income (gross income less expenses)2013-12-31$104,258
Net plan assets at end of year (total assets less liabilities)2013-12-31$649,739
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$545,481
Assets. Value of participant loans2013-12-31$44,525
Total contributions received or receivable from employer(s)2013-12-31$4,132
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Funding deficiency by the employer to the plan for this plan year2013-12-31$0
Minimum employer required contribution for this plan year2013-12-31$0
Amount contributed by the employer to the plan for this plan year2013-12-31$0
2012 : METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$79,352
Expenses. Total of all expenses incurred2012-12-31$37,250
Benefits paid (including direct rollovers)2012-12-31$37,180
Total plan assets at end of year2012-12-31$545,481
Total plan assets at beginning of year2012-12-31$503,379
Value of fidelity bond covering the plan2012-12-31$50,000
Total contributions received or receivable from participants2012-12-31$20,286
Expenses. Other expenses not covered elsewhere2012-12-31$70
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$55,087
Net income (gross income less expenses)2012-12-31$42,102
Net plan assets at end of year (total assets less liabilities)2012-12-31$545,481
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$503,379
Assets. Value of participant loans2012-12-31$54,842
Total contributions received or receivable from employer(s)2012-12-31$3,979
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
2011 : METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$3,309
Expenses. Total of all expenses incurred2011-12-31$20,826
Benefits paid (including direct rollovers)2011-12-31$20,686
Total plan assets at end of year2011-12-31$503,379
Total plan assets at beginning of year2011-12-31$520,896
Value of fidelity bond covering the plan2011-12-31$50,000
Total contributions received or receivable from participants2011-12-31$25,946
Expenses. Other expenses not covered elsewhere2011-12-31$140
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-27,465
Net income (gross income less expenses)2011-12-31$-17,517
Net plan assets at end of year (total assets less liabilities)2011-12-31$503,379
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$520,896
Assets. Value of participant loans2011-12-31$100,329
Total contributions received or receivable from employer(s)2011-12-31$4,828
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
2010 : METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$102,938
Expenses. Total of all expenses incurred2010-12-31$168,676
Benefits paid (including direct rollovers)2010-12-31$168,606
Total plan assets at end of year2010-12-31$520,896
Total plan assets at beginning of year2010-12-31$586,634
Value of fidelity bond covering the plan2010-12-31$50,000
Total contributions received or receivable from participants2010-12-31$26,284
Expenses. Other expenses not covered elsewhere2010-12-31$70
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$71,731
Net income (gross income less expenses)2010-12-31$-65,738
Net plan assets at end of year (total assets less liabilities)2010-12-31$520,896
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$586,634
Assets. Value of participant loans2010-12-31$34,060
Total contributions received or receivable from employer(s)2010-12-31$4,923
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
2009 : METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN

2014: METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: METZNER'S CULLIGAN QUALITY WATER, INC. 401(K) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-008553
Policy instance 1
Insurance contract or identification numberGA-008553
Number of Individuals Covered12
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,346
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,346
Insurance broker organization code?3
Insurance broker nameSTIFEL NICOLAUS & COMPANY INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-008553
Policy instance 1
Insurance contract or identification numberGA-008553
Number of Individuals Covered10
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,251
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,251
Insurance broker organization code?3
Insurance broker nameSTIFEL NICOLAUS & CO INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-008553
Policy instance 1
Insurance contract or identification numberGA-008553
Number of Individuals Covered9
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,081
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,081
Insurance broker organization code?3
Insurance broker nameSTIFEL NICOLAUS & CO INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-008553
Policy instance 1
Insurance contract or identification numberGA-008553
Number of Individuals Covered8
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,095
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-008553
Policy instance 1
Insurance contract or identification numberGA-008553
Number of Individuals Covered9
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,254
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,254
Insurance broker organization code?3
Insurance broker nameSTIFEL NICOLAUS & CO INC

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